) elevations in perceived stress, cardiovascular activity, and peak cortisol response at 30 min ( versus μg·dL−1, resp.) during the stress compared with the control condition; however, 3 h OGTT glucose and insulin responses were similar between conditions. The CGM data suggested a 30–40 min postchallenge delay in peak glucose response and attenuated glucose clearance over the 6 h following the stress condition, but these alterations were not statistically significant. Healthy older people may demonstrate minimal disruption in metabolic resiliency following everyday psychological stress.">
应对急性心理物理压力和24小时血糖控制在健康老年人</gydF4y2Batitle>
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<span class="articleHeader__meta_doiLink"><a href="https://doi.org/10.1155/2012/803864" aria-label="Doi-link" target="_blank" rel="noreferrer">https://doi.org/10.1155/2012/803864</gydF4y2Baa></span>
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<h1 class="articleHeader__title">应对急性心理物理压力和24小时血糖控制在健康老年人</gydF4y2Bah1>
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<span class="articleHeader__authors_author"><strong>洛雷塔DiPietro</gydF4y2Bastrong><a href="//www.newsama.com/cdn-cgi/l/email-protection" aria-label="Mail Option"><span role="img" class="anticon">
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</svg></span></a>,<gydF4y2Basup>1、2、3</gydF4y2Basup></span>
<span class="articleHeader__authors_author">凯瑟琳·w·Yeckel<gydF4y2Ba!-- -->,<gydF4y2Basup>1、2</gydF4y2Basup></span>
<span class="articleHeader__authors_author">和<gydF4y2Ba!-- -->安德烈Gribok<gydF4y2Basup>4</gydF4y2Basup></span>
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<strong>学术编辑器:</gydF4y2Bastrong>
<span>Hiroshi鼻子</gydF4y2Baspan>
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<div class="articleHeader__timeline">
<div class="articleHeader__timeline_item ">
<strong>收到了</gydF4y2Bastrong>
<span>2012年3月20日</gydF4y2Baspan>
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<div class="articleHeader__timeline_item ">
<strong>接受</gydF4y2Bastrong>
<span>2012年5月31日</gydF4y2Baspan>
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<div class="articleHeader__timeline_item articleHeader__timeline_item_sticky">
<strong>发表</gydF4y2Bastrong>
<span>08年7月2012年</gydF4y2Baspan>
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</div>
<div class="articleBody">
<div class="xml-content">
<h4 class="header" id="abstract">文摘</gydF4y2Bah4>
<p>我们检查了应激反应性之间的关系和24小时血糖控制在17不活跃,健康老年人(≥60岁)在一本小说心理物理压力,一个坐着的控制条件。血浆皮质醇测定的压力和恢复时间。血糖控制决心在随后3 h口服葡萄糖耐量试验(OGTT)和超过24小时<gydF4y2Bai>通过</gydF4y2Bai>连续血糖监测(CGM)。我们观察到显著(<gydF4y2Basvg height="11.25" id="M1" style="vertical-align:-0.30096pt;width:56.150002px;" version="1.1" viewbox="0 0 56.150002 11.25" width="56.150002" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,11.25)">
<g transform="translate(72,-63)">
<text transform="matrix(1,0,0,-1,-71.95,63.35)">
<tspan style="font-size: 12.50px; " x="0" y="0">
</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="10.890113" y="0">
<</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="22.930502" y="0">
0</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="29.182001" y="0">
。</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="32.307751" y="0">
0</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="38.559254" y="0">
5</gydF4y2Batspan>
</text>
</g>
</g>
</svg>)海拔在感知压力、心血管活动和峰值皮质醇反应30分钟(<gydF4y2Basvg height="12.175" id="M2" style="vertical-align:-1.09097pt;width:64.662498px;" version="1.1" viewbox="0 0 64.662498 12.175" width="64.662498" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,12.175)">
<g transform="translate(72,-62.26)">
<text transform="matrix(1,0,0,-1,-71.95,63.4)">
<tspan style="font-size: 12.50px; " x="0" y="0">
1</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="6.2515001" y="0">
0</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="12.503" y="0">
。</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="15.62875" y="0">
6</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="24.655916" y="0">
±</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="35.996136" y="0">
3</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="42.247639" y="0">
。</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="45.373386" y="0">
1</gydF4y2Batspan>
</text>
</g>
</g>
</svg>与<gydF4y2Basvg height="12.175" id="M3" style="vertical-align:-1.09097pt;width:56.849998px;" version="1.1" viewbox="0 0 56.849998 12.175" width="56.849998" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,12.175)">
<g transform="translate(72,-62.26)">
<text transform="matrix(1,0,0,-1,-71.95,63.4)">
<tspan style="font-size: 12.50px; " x="0" y="0">
8</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="6.2515001" y="0">
。</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="9.3772497" y="0">
6</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="18.404415" y="0">
±</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="29.744637" y="0">
2</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="35.996136" y="0">
。</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="39.121887" y="0">
6</gydF4y2Batspan>
</text>
</g>
</g>
</svg><i>μ</gydF4y2Bai>g·dL<gydF4y2Basup>−1</gydF4y2Basup>、职责)在压力与控制条件;然而,3 h OGTT葡萄糖和胰岛素反应之间的相似条件。CGM数据表明30 - 40分钟postchallenge延迟葡萄糖响应峰值和减毒葡萄糖间隙6 h后应力状态,但这些变化在统计学上没有显著意义。健康的老年人可能证明在代谢后弹性的日常心理压力的影响最小。</gydF4y2Bap>
<span class="end-abs"></span>
<h4 id="introduction">1。介绍</gydF4y2Bah4>
<p>“压力”是一种常见的和自适应组件的交互与环境(<gydF4y2Baa href="#B1">1</gydF4y2Baa>),而<gydF4y2Bai>allostasis</gydF4y2Bai>是指身体的能力(即恢复稳定。,homeostasis) when confronted by various environmental challenges through the activation of neural, neuroendocrine, and neuroendocrine-immune responses [<a href="#B2">2</gydF4y2Baa>]。有证据表明衰老动物模型<gydF4y2Bai>本身</gydF4y2Bai>改变适应能力,虽然在人类的数据是不确定的<gydF4y2Baa href="#B3">3</gydF4y2Baa>]。尽管如此,老年人的特点是减少物理功能(如视觉、力量,和反应时间),这可能会让正常的日常经验和挑战(像驾驶汽车或过马路)压力更大(<gydF4y2Baa href="#B4">4</gydF4y2Baa>]。因此,老年人可能更频繁的接触压力,以及一个妥协适当反应能力。有明显的个体差异在个人如何应对环境挑战,然而,这可能是由于遗传的相互作用,发展,教育和生活经历<gydF4y2Baa href="#B5">5</gydF4y2Baa>,<gydF4y2Baa href="#B6">6</gydF4y2Baa>]。此外,有大量的非均质性对老化模式(<gydF4y2Baa href="#B7">7</gydF4y2Baa>这样一些年长的人似乎比其他的更有弹性的生理后果不同的环境挑战。弹性心理物理压力因此可能被视为成功老化的一个重要指标。</gydF4y2Bap>
<p>到目前为止,大部分压力反应的实验研究和健康一直专注于心血管功能。尽管流行病学数据描述和可怜的糖尿病控制不良心理因素之间的关系(<gydF4y2Baa href="#B6">6</gydF4y2Baa>),急性代谢控制心理压力的危害通常很难演示实验(<gydF4y2Baa href="#B8">8</gydF4y2Baa>,<gydF4y2Baa href="#B9">9</gydF4y2Baa>]。此外,该研究调查了应激反应的作用在血糖控制包括主要是年轻人<gydF4y2Baa href="#B8">8</gydF4y2Baa>,<gydF4y2Baa href="#B10">10</gydF4y2Baa>),或者那些已经建立了1型或2型糖尿病<gydF4y2Baa href="#B9">9</gydF4y2Baa>),使用特定的任务或应对自然灾害<gydF4y2Baa href="#B11">11</gydF4y2Baa>)通常不是每天遇到的老年人,并且只考虑血糖反应超过2 - 3小时。本研究的目的是检查之间的关系压力反应和血糖控制在24小时健康的老年人,使用共同的“日常生活”压力的挑战。我们假设(1)老年受试者能展示升高心血管和荷尔蒙反应这一挑战而控制条件,(2)一个夸张的应激反应会导致在短期内显著影响血糖控制(即。3 h),但不超过24小时。由于本研究样本的健壮的健康状况,我们建议改变代谢控制在短期内将规范化这一天的剩下的时间里。据我们所知,没有测试这些假设在任何年龄的健康人使用连续血糖监测。</gydF4y2Bap>
<h4 id="methods">2。方法</gydF4y2Bah4>
<h5 id="sec2.1">2.1。研究对象</gydF4y2Bah5>
<p>老年人(≥60岁)志愿者(<gydF4y2Basvg height="11.0375" id="M4" style="vertical-align:-0.17555pt;width:40.625px;" version="1.1" viewbox="0 0 40.625 11.0375" width="40.625" xmlns="http://www.w3.org/2000/svg">
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6</gydF4y2Batspan>
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</svg>男性和11个女性)被广告招募社区老年活动中心在纽黑文县就越大。合格的受试者不吸烟,而不是服用β受体阻断剂,降糖药物,抗抑郁药,或报告一个饮酒> 2饮料/天。消除干扰的影响心血管健康压力反应和血糖控制,所有科目都不活跃(< 2天/周中等强度体力活动持续时间超过10分钟)。感兴趣的对象首先是管理认知功能筛选使用含有短便携式精神状态问卷(<gydF4y2Baa href="#B12">12</gydF4y2Baa>]。所有人达到5分或更少的正确答案SPMSQ被排除在进一步研究。感兴趣的主题会议认知功能标准然后给出筛选口服葡萄糖耐量试验(OGTT(负载)75克)排除未确诊的2型糖尿病患者。那些空腹血浆葡萄糖浓度≥110毫克<gydF4y2Bai>·</gydF4y2Bai>戴斯。莱纳姆:<gydF4y2Basup>−1</gydF4y2Basup>,2 h postchallenge测量≥140毫克<gydF4y2Bai>·</gydF4y2Bai>戴斯。莱纳姆:<gydF4y2Basup>−1</gydF4y2Basup>或至少一个其他postchallenge≥180毫克<gydF4y2Bai>·</gydF4y2Bai>戴斯。莱纳姆:<gydF4y2Basup>−1</gydF4y2Basup>被排除在进一步研究。合格的志愿者的所有细节研究向他们解释和一个表单来显示他们的知情同意签署。批准的协议都是人类的耶鲁大学医学院的调查委员会。</gydF4y2Bap>
<h5 id="sec2.2">2.2。研究协议</gydF4y2Bah5>
<p>每项研究课题进行了两个独立的研究条件:(1)实际的心理物理压力挑战,(2)一个坐着的控制条件。这两个条件被随机命令和间距为约2 - 4周。因为抑郁症可能影响压力反应与胰岛素敏感性的关系,受试者管理中心流行病学Studies-Depression(鉴定)<gydF4y2Baa href="#B13">13</gydF4y2Baa>]规模(20块的抑郁症状的频率在过去一周)一个星期前他们第一次研究。感知到的压力量表(PSS) (<gydF4y2Baa href="#B14">14</gydF4y2Baa>](衡量感知心理压力的问题超过前一个月)也是管理。</gydF4y2Bap>
<p>当天的测试中,受试者抵达医院研究中心(HRU)耶鲁大学临床研究中心(YCCI)上午8:00在禁食状态。我们选择应用应力刺激禁食(而不是餐后)状态,以避免葡萄糖的量预计广泛的旅行在这些老年人,它可能会掩盖任何与压力相关的对血糖控制的影响。受试者体重和腹部围<gydF4y2Baa href="#B15">15</gydF4y2Baa>)是测量。主题然后坐在semirecumbent位置在一个肘前的静脉导管的位置。血液样本是(15毫升)基底测定葡萄糖,胰岛素、皮质醇。大约在上午8:30,探测器的连续葡萄糖监测系统(CGM)(美国二分音符,这起案件,CA)插入在腹壁皮下CGM是校准时受试者安静地坐在一个60分钟的卧位平衡时期。平衡期后,一个基线血液样本研究了基质和应激激素。上午大约9:30,受试者静静地坐了30分钟阅读或听音乐(坐在控制)或被给予指令任务参与心理物理的挑战。30分钟后心理物理挑战(或坐在控制条件),受试者静静地坐了一个30分钟的恢复时期。血液样本被每15分钟对实验(或控制)和复苏时期,和心率和血压连续测量<gydF4y2Bai>通过</gydF4y2Bai>一个自动化设备(Colin医疗器械,小牧市日本),每5分钟记录。间隙测量血糖浓度也不断在此期间使用CGM。恢复期(~ 10:30)后,受试者可以空白,从测试椅子搬到隔壁床为了执行3 h OGTT。OGTT(~下午1:30)后,受试者美联储一个标准化的午餐(60%碳水化合物;20%的蛋白质;~ 32千卡<gydF4y2Bai>·</gydF4y2Bai>公斤的体重<gydF4y2Basup>−1</gydF4y2Basup>/天),指示在国内使用CGM和提供一个标准化的晚餐之前从HRU被释放。受试者被要求休息安静地在下午和晚上的其余部分,在~下午6点吃晚餐,晚上十点钟和退休。第二天早晨,受试者参观了在家里为了获得空腹血样的血糖和皮质醇,以及去除葡萄糖传感器探头。</gydF4y2Bap>
<h5 id="sec2.3">2.3。心理物理压力的挑战</gydF4y2Bah5>
<p>自动化的心理物理测试(APT)(国家公共服务研究中心,1996年)<gydF4y2Baa href="#B16">16</gydF4y2Baa>,<gydF4y2Baa href="#B17">17</gydF4y2Baa>)是一种计算机化的系列<gydF4y2Bai>时间性能的措施</gydF4y2Bai>如简单反应时间、选择反应、视觉跟踪、静态和动态灵敏度和信息处理。恰当的包含一个电池的物品,测试特定的汽车相关的知觉和认知能力由国家公共服务研究所开发的。当我们使用这些相关的任务仅仅引起应激反应,实际上我们没有得分的表现。受试者被告知,我们当时是在测试他们驾驶性能作为研究的一部分,心理物理能力在老年人和糖尿病的风险。提高社会评价的组成部分心理物理的挑战,表现“监控”耻辱摄像机。后立即挑战(或控制),评价他们的主题<gydF4y2Bai>水平的威胁</gydF4y2Bai>使用8视觉模拟量表(100毫米)。</gydF4y2Bap>
<h5 id="sec2.4">2.4。口服葡萄糖耐量试验</gydF4y2Bah5>
<p>测量瞬时中断后血糖控制压力的挑战,一个75 g进行OGTT根据美国糖尿病协会的指导方针<gydF4y2Baa href="#B18">18</gydF4y2Baa>]。收集血液样本(5毫升)之前(−15 0分钟)和后(5、10、20、30、45、60、90、120、150和180分钟)葡萄糖摄取葡萄糖和胰岛素浓度的测定。OGTT终止时葡萄糖值对于一个给定的主题回到在10毫克<gydF4y2Bai>·</gydF4y2Bai>戴斯。莱纳姆:<gydF4y2Basup>−1</gydF4y2Basup>基线;否则受试者监控超过3小时。</gydF4y2Bap>
<h5 id="sec2.5">2.5。连续血糖监测</gydF4y2Bah5>
<p>全日制的间隙葡萄糖档案收集使用cgm超过24小时。设备提供葡萄糖模式和趋势数据24 h(每天多达288次<gydF4y2Baa href="#B19">19</gydF4y2Baa>,<gydF4y2Baa href="#B20">20.</gydF4y2Baa>)通过测量间隙和葡萄糖在葡萄糖氧化酶接口转换成过氧化氢,当时氧化产生电流信号(<gydF4y2Baa href="#B19">19</gydF4y2Baa>]。这个信号正比于间质葡萄糖浓度和存储在监视器。存储测量电流的数据然后被转化为葡萄糖浓度数据收集完成后使用一个红外连接个人电脑和数据分析使用CGM系统解决方案软件(版本3.0 b)。四到六实际血糖值(获得<gydF4y2Bai>通过</gydF4y2Bai>glucometer(美国美敦力公司,这起案件,CA))进入监测为了调整间隙读数。除了连续阅读,在24小时内一定数量的汇总数据生成CGM:(1)平均组;(2)平均2 h餐后;(3)24小时平均血糖浓度。</gydF4y2Bap>
<h5 id="sec2.6">2.6。评级的感知到的压力和威胁</gydF4y2Bah5>
<p>心理物理的挑战,完成后,受试者认为他们的感知到的压力和威胁到社会自我使用8视觉模拟(100毫米)量表(<gydF4y2Baa href="#B3">3</gydF4y2Baa>]。这些量表评估:(1)所面临的挑战是多么困难;(2)如何相信他们在他们的表现;(3)多少他们亲自参与的挑战;(4)如何控制情况;(5)如何威胁情况;(6)有多少压力,他们经历由于失败;(7)有多少压力,他们感觉由于时间限制;(8)的内容是如何与他们的性能。规模的一端的评级是“不”(0毫米)其他(100毫米),评级“极”。</p>
<h5 id="sec2.7">2.7。应激激素和底物的分析</gydF4y2Bah5>
<p>所有血液样本YCCI的核心实验室进行分析。等离子体<gydF4y2Bai>皮质醇</gydF4y2Bai>浓度测定放射免疫检定法(诊断产品公司,洛杉矶、钙、美国)。等离子体<gydF4y2Bai>葡萄糖</gydF4y2Bai>分析了葡萄糖氧化酶法(2300年YSI黄色泉仪器,黄色的弹簧,哦,美国)。等离子体免疫反应性的<gydF4y2Bai>胰岛素</gydF4y2Bai>浓度测定用双抗体放射免疫检定法(美国诊断,韦伯斯特,TX)。</gydF4y2Bap>
<h5 id="sec2.8">2.8。统计分析</gydF4y2Bah5>
<p>单变量统计(<gydF4y2Basvg height="13.85" id="M5" style="vertical-align:-2.53308pt;width:48.450001px;" version="1.1" viewbox="0 0 48.450001 13.85" width="48.450001" xmlns="http://www.w3.org/2000/svg">
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</svg>)首先上生成研究变量用于描述。总面积和增量区域下的皮质醇,以及OGTT血糖和胰岛素曲线下(AUC),梯形法测定。此外,我们认为皮质醇响应峰值,以及基底皮质醇浓度在早晨前和后的第二天早上使用结合的心理挑战皮质醇响应曲线作为额外的指标综合应激反应。意味着不同的生理反应变量之间的两个条件是使用配对进行了测试<gydF4y2Basvg height="9.125" id="M6" style="vertical-align:-0.11285pt;width:5.0124998px;" version="1.1" viewbox="0 0 5.0124998 9.125" width="5.0124998" xmlns="http://www.w3.org/2000/svg">
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</svg>测试。应激反应之间的关系和影响血糖控制(AUC和CGM总结变量)确定使用方差分析(方差分析)重复措施。原始CGM数据然后被转移到StatLab和平滑使用三次样条函数经验选择平滑参数。个人和汇集CGM曲线检测的数据研究条件确定两者之间的反应程度的变化情况。统计学意义是一个α水平为0.05。</gydF4y2Bap>
<h4 id="results">3所示。结果</gydF4y2Bah4>
<p>研究样本的年龄<gydF4y2Basvg height="12.05" id="M7" style="vertical-align:-1.09097pt;width:41.224998px;" version="1.1" viewbox="0 0 41.224998 12.05" width="41.224998" xmlns="http://www.w3.org/2000/svg">
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</svg>年,从60到88年。平均而言,受试者超重(<gydF4y2Basvg height="12.05" id="M8" style="vertical-align:-1.09097pt;width:41.224998px;" version="1.1" viewbox="0 0 41.224998 12.05" width="41.224998" xmlns="http://www.w3.org/2000/svg">
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2</gydF4y2Batspan>
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7</gydF4y2Batspan>
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4</gydF4y2Batspan>
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</svg>公斤<gydF4y2Bai>·</gydF4y2Bai>米<gydF4y2Basup>−2</gydF4y2Basup>),但血压正常的人(<gydF4y2Basvg height="12.05" id="M9" style="vertical-align:-1.09097pt;width:56.849998px;" version="1.1" viewbox="0 0 56.849998 12.05" width="56.849998" xmlns="http://www.w3.org/2000/svg">
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2</gydF4y2Batspan>
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7</gydF4y2Batspan>
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±</gydF4y2Batspan>
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1</gydF4y2Batspan>
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0</gydF4y2Batspan>
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</svg>/<gydF4y2Basvg height="12.05" id="M10" style="vertical-align:-1.09097pt;width:49.037498px;" version="1.1" viewbox="0 0 49.037498 12.05" width="49.037498" xmlns="http://www.w3.org/2000/svg">
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7</gydF4y2Batspan>
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3</gydF4y2Batspan>
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±</gydF4y2Batspan>
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<tspan style="font-size: 12.50px; " x="29.744637" y="0">
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<tspan style="font-size: 12.50px; " x="39.121887" y="0">
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</svg>毫米),时间压力(<gydF4y2Basvg height="12.175" id="M18" style="vertical-align:-1.09097pt;width:72.474998px;" version="1.1" viewbox="0 0 72.474998 12.175" width="72.474998" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,12.175)">
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<tspan style="font-size: 12.50px; " x="15.62875" y="0">
8</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="24.655916" y="0">
±</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="35.996136" y="0">
3</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="42.247639" y="0">
9</gydF4y2Batspan>
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<tspan style="font-size: 12.50px; " x="51.624886" y="0">
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<g transform="matrix(1.25,0,0,-1.25,0,12.175)">
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<tspan style="font-size: 12.50px; " x="15.62875" y="0">
4</gydF4y2Batspan>
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±</gydF4y2Batspan>
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2</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="42.247639" y="0">
8</gydF4y2Batspan>
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<g transform="matrix(1.25,0,0,-1.25,0,12.175)">
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6</gydF4y2Batspan>
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。</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="15.62875" y="0">
7</gydF4y2Batspan>
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±</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="35.996136" y="0">
3</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="42.247639" y="0">
4</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="48.499138" y="0">
。</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="51.624886" y="0">
3</gydF4y2Batspan>
</text>
</g>
</g>
</svg>与<gydF4y2Basvg height="12.2375" id="M21" style="vertical-align:-1.09097pt;width:56.849998px;" version="1.1" viewbox="0 0 56.849998 12.2375" width="56.849998" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,12.2375)">
<g transform="translate(72,-62.21)">
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。</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="9.3772497" y="0">
0</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="18.404415" y="0">
±</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="29.744637" y="0">
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<tspan style="font-size: 12.50px; " x="35.996136" y="0">
。</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="39.121887" y="0">
8</gydF4y2Batspan>
</text>
</g>
</g>
</svg>毫米)明显更大的心理物理的挑战后,与控制条件(<gydF4y2Basvg height="11.0625" id="M22" style="vertical-align:-0.30096pt;width:56.150002px;" version="1.1" viewbox="0 0 56.150002 11.0625" width="56.150002" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,11.0625)">
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<tspan style="font-size: 12.50px; " x="0" y="0">
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<tspan style="font-size: 12.50px; " x="10.890113" y="0">
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<tspan style="font-size: 12.50px; " x="22.930502" y="0">
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<tspan style="font-size: 12.50px; " x="29.182001" y="0">
。</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="32.307751" y="0">
0</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="38.559254" y="0">
1</gydF4y2Batspan>
</text>
</g>
</g>
</svg>)。这些感知数据证实了显著差异在心血管反应的收缩压和舒张压和心率之间的两个条件(<gydF4y2Basvg height="11.0625" id="M23" style="vertical-align:-0.30096pt;width:56.150002px;" version="1.1" viewbox="0 0 56.150002 11.0625" width="56.150002" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,11.0625)">
<g transform="translate(72,-63.15)">
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<tspan style="font-size: 12.50px; " x="0" y="0">
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<tspan style="font-size: 12.50px; " x="10.890113" y="0">
<</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="22.930502" y="0">
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。</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="32.307751" y="0">
0</gydF4y2Batspan>
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1</gydF4y2Batspan>
</text>
</g>
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</svg>;图<gydF4y2Baa href="//www.newsama.com/journals/jar/2012/803864/fig1/" target="_blank">1</gydF4y2Baa>)。</gydF4y2Bap>
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<span class="caption-text">图1</gydF4y2Baspan>
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<td>的差异(一)收缩压和舒张压(b)和(c)心率反应在压力挑战(实线)和控制(折线)条件。数据意味着±se;<gydF4y2Basvg height="10.8125" id="M24" style="vertical-align:-0.10033pt" version="1.1" viewbox="0 0 48.4375 10.8125" width="48.4375" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,10.8125)">
<g transform="translate(72,-63.35)">
<text transform="matrix(1,0,0,-1,-71.95,63.5)">
<tspan style="font-size: 12.50px; " x="0" y="0">
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<tspan style="font-size: 12.50px; " x="14.103384" y="0">
=</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="26.143772" y="0">
1</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="32.395271" y="0">
7</gydF4y2Batspan>
</text>
</g>
</g>
</svg>。</gydF4y2Batd>
</tr>
</tbody>
</table>
</div>
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<p>平均皮质醇AUC响应实验和恢复期间没有明显更高的压力相对控制条件,除了峰值响应在30分钟(<gydF4y2Basvg height="12.175" id="M25" style="vertical-align:-1.09097pt;width:64.662498px;" version="1.1" viewbox="0 0 64.662498 12.175" width="64.662498" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,12.175)">
<g transform="translate(72,-62.26)">
<text transform="matrix(1,0,0,-1,-71.95,63.4)">
<tspan style="font-size: 12.50px; " x="0" y="0">
1</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="6.2515001" y="0">
0</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="12.503" y="0">
。</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="15.62875" y="0">
6</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="24.655916" y="0">
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<tspan style="font-size: 12.50px; " x="42.247639" y="0">
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<tspan style="font-size: 12.50px; " x="45.373386" y="0">
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。</gydF4y2Batspan>
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±</gydF4y2Batspan>
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<tspan style="font-size: 12.50px; " x="39.121887" y="0">
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</svg><i>μ</gydF4y2Bai>g<gydF4y2Bai>·</gydF4y2Bai>戴斯。莱纳姆:<gydF4y2Basup>−1</gydF4y2Basup>、职责;<gydF4y2Basvg height="11.25" id="M27" style="vertical-align:-0.30096pt;width:56.150002px;" version="1.1" viewbox="0 0 56.150002 11.25" width="56.150002" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,11.25)">
<g transform="translate(72,-63)">
<text transform="matrix(1,0,0,-1,-71.95,63.35)">
<tspan style="font-size: 12.50px; " x="0" y="0">
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<tspan style="font-size: 12.50px; " x="10.890113" y="0">
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<tspan style="font-size: 12.50px; " x="38.559254" y="0">
5</gydF4y2Batspan>
</text>
</g>
</g>
</svg>)。当数据被平均年龄分层,然而,皮质醇响应峰值应力状态明显放大的主题< 70年(<gydF4y2Basvg height="11.0375" id="M28" style="vertical-align:-0.27588pt;width:35.099998px;" version="1.1" viewbox="0 0 35.099998 11.0375" width="35.099998" xmlns="http://www.w3.org/2000/svg">
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9</gydF4y2Batspan>
</text>
</g>
</g>
</svg>),但逆转这些≥70年(<gydF4y2Basvg height="10.9125" id="M29" style="vertical-align:-0.17555pt;width:35.099998px;" version="1.1" viewbox="0 0 35.099998 10.9125" width="35.099998" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,10.9125)">
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8</gydF4y2Batspan>
</text>
</g>
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</svg>)(图<gydF4y2Baa href="//www.newsama.com/journals/jar/2012/803864/fig2/" target="_blank">2</gydF4y2Baa>)。例如,在压力条件下,30分钟皮质醇浓度从基线增加22% (<gydF4y2Basvg height="11.25" id="M30" style="vertical-align:-0.30096pt;width:56.150002px;" version="1.1" viewbox="0 0 56.150002 11.25" width="56.150002" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,11.25)">
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</text>
</g>
</g>
</svg>年轻的学科,但<gydF4y2Bai>减少</gydF4y2Bai>7%年龄在70岁及以上。原因造成这种皮质醇的变化反应明显高于基础水平在这些≥70岁,相比之下,年轻的同行(<gydF4y2Basvg height="11.25" id="M31" style="vertical-align:-0.30096pt;width:56.150002px;" version="1.1" viewbox="0 0 56.150002 11.25" width="56.150002" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,11.25)">
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<tspan style="font-size: 12.50px; " x="0" y="0">
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0</gydF4y2Batspan>
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。</gydF4y2Batspan>
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0</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="38.559254" y="0">
5</gydF4y2Batspan>
</text>
</g>
</g>
</svg>)。</gydF4y2Bap>
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<span class="caption-text">图2</gydF4y2Baspan>
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<td>皮质醇反应之间的应力状态(实线)和控制(折线)年龄条件。年龄段是基于中值降低的分布。数据意味着±se;<gydF4y2Basvg height="10.8125" id="M32" style="vertical-align:-0.10033pt" version="1.1" viewbox="0 0 48.4375 10.8125" width="48.4375" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,10.8125)">
<g transform="translate(72,-63.35)">
<text transform="matrix(1,0,0,-1,-71.95,63.5)">
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<tspan style="font-size: 12.50px; " x="14.103384" y="0">
=</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="26.143772" y="0">
1</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="32.395271" y="0">
7</gydF4y2Batspan>
</text>
</g>
</g>
</svg>;<gydF4y2Basvg height="11.9" id="M33" style="vertical-align:-0.30096pt" version="1.1" viewbox="0 0 62.487499 11.9" width="62.487499" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,11.9)">
<g transform="translate(72,-62.48)">
<text transform="matrix(1,0,0,-1,-71.95,67.83)">
<tspan style="font-size: 8.75px; " x="0" y="0">
∗</gydF4y2Batspan>
</text>
<text transform="matrix(1,0,0,-1,-66.87,62.83)">
<tspan style="font-size: 12.50px; " x="0" y="0">
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<tspan style="font-size: 12.50px; " x="10.890113" y="0">
<</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="22.930502" y="0">
0</gydF4y2Batspan>
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。</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="32.307751" y="0">
0</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="38.559254" y="0">
5</gydF4y2Batspan>
</text>
</g>
</g>
</svg>。</gydF4y2Batd>
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</tbody>
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<p>OGTT-derived血糖和胰岛素响应曲线后,压力和控制条件如图<gydF4y2Baa href="//www.newsama.com/journals/jar/2012/803864/fig3/" target="_blank">3</gydF4y2Baa>。虽然明显升高,表明受损的血糖控制,两个条件的曲线非常相似,除了血糖峰值响应从60到90分钟,胰岛素反应峰值变化从90年到120分钟后的应力状态。这些发现被年龄分层后的数据(< 70 /≥70岁)。然而,在这个图中,值得注意的是平均2 h葡萄糖浓度的筛选OGTT,显著降低(<gydF4y2Basvg height="12.05" id="M34" style="vertical-align:-1.09097pt;width:56.849998px;" version="1.1" viewbox="0 0 56.849998 12.05" width="56.849998" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,12.05)">
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<text transform="matrix(1,0,0,-1,-71.95,63.5)">
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3</gydF4y2Batspan>
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0</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="21.530167" y="0">
±</gydF4y2Batspan>
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2</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="39.121887" y="0">
2</gydF4y2Batspan>
</text>
</g>
</g>
</svg>毫克<gydF4y2Bai>·</gydF4y2Bai>戴斯。莱纳姆:<gydF4y2Basup>−1</gydF4y2Basup>;<gydF4y2Basvg height="11.25" id="M35" style="vertical-align:-0.30096pt;width:56.150002px;" version="1.1" viewbox="0 0 56.150002 11.25" width="56.150002" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,11.25)">
<g transform="translate(72,-63)">
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<tspan style="font-size: 12.50px; " x="0" y="0">
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5</gydF4y2Batspan>
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</g>
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</svg>比2 h值压力(后)<gydF4y2Basvg height="12.05" id="M36" style="vertical-align:-1.09097pt;width:56.849998px;" version="1.1" viewbox="0 0 56.849998 12.05" width="56.849998" xmlns="http://www.w3.org/2000/svg">
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2</gydF4y2Batspan>
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±</gydF4y2Batspan>
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3</gydF4y2Batspan>
</text>
</g>
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</svg>毫克<gydF4y2Bai>·</gydF4y2Bai>戴斯。莱纳姆:<gydF4y2Basup>−1</gydF4y2Basup>)或控制(<gydF4y2Basvg height="12.175" id="M37" style="vertical-align:-1.09097pt;width:56.849998px;" version="1.1" viewbox="0 0 56.849998 12.175" width="56.849998" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,12.175)">
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<tspan style="font-size: 12.50px; " x="0" y="0">
1</gydF4y2Batspan>
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7</gydF4y2Batspan>
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4</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="21.530167" y="0">
±</gydF4y2Batspan>
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6</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="39.121887" y="0">
0</gydF4y2Batspan>
</text>
</g>
</g>
</svg>毫克<gydF4y2Bai>·</gydF4y2Bai>戴斯。莱纳姆:<gydF4y2Basup>−1</gydF4y2Basup>)条件。葡萄糖曲线获得<gydF4y2Bai>通过</gydF4y2Bai>CGM / 24小时显示为每个条件图<gydF4y2Baa href="//www.newsama.com/journals/jar/2012/803864/fig4/" target="_blank">4</gydF4y2Baa>并建议向右移和30 - 40分钟延迟postchallenge葡萄糖响应峰值应力条件后,与血糖水平升高相对控制条件,只要6个小时。然而,我们观察到没有区别,平均24 h葡萄糖浓度(<gydF4y2Basvg height="12.05" id="M38" style="vertical-align:-1.09097pt;width:80.287498px;" version="1.1" viewbox="0 0 80.287498 12.05" width="80.287498" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,12.05)">
<g transform="translate(72,-62.36)">
<text transform="matrix(1,0,0,-1,-71.95,63.5)">
<tspan style="font-size: 12.50px; " x="0" y="0">
1</gydF4y2Batspan>
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1</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="12.503" y="0">
1</gydF4y2Batspan>
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。</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="21.880251" y="0">
7</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="30.907415" y="0">
±</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="42.247639" y="0">
1</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="48.499138" y="0">
2</gydF4y2Batspan>
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3</gydF4y2Batspan>
</text>
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</svg>与<gydF4y2Basvg height="12.05" id="M39" style="vertical-align:-1.09097pt;width:80.287498px;" version="1.1" viewbox="0 0 80.287498 12.05" width="80.287498" xmlns="http://www.w3.org/2000/svg">
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1</gydF4y2Batspan>
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4</gydF4y2Batspan>
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。</gydF4y2Batspan>
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0</gydF4y2Batspan>
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±</gydF4y2Batspan>
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2</gydF4y2Batspan>
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4</gydF4y2Batspan>
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0</gydF4y2Batspan>
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</g>
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</svg>毫克<gydF4y2Bai>·</gydF4y2Bai>戴斯。莱纳姆:<gydF4y2Basup>−1</gydF4y2Basup>),或者平均prelunch浓度(<gydF4y2Basvg height="12.05" id="M40" style="vertical-align:-1.09097pt;width:80.287498px;" version="1.1" viewbox="0 0 80.287498 12.05" width="80.287498" xmlns="http://www.w3.org/2000/svg">
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</svg>、职责)和峰态(<gydF4y2Basvg height="12.05" id="M47" style="vertical-align:-1.09097pt;width:72.474998px;" version="1.1" viewbox="0 0 72.474998 12.05" width="72.474998" xmlns="http://www.w3.org/2000/svg">
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。</gydF4y2Batspan>
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3</gydF4y2Batspan>
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8</gydF4y2Batspan>
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±</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="35.996136" y="0">
0</gydF4y2Batspan>
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。</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="45.373386" y="0">
9</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="51.624886" y="0">
1</gydF4y2Batspan>
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</svg>与<gydF4y2Basvg height="12.05" id="M48" style="vertical-align:-1.09097pt;width:72.474998px;" version="1.1" viewbox="0 0 72.474998 12.05" width="72.474998" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,12.05)">
<g transform="translate(72,-62.36)">
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<tspan style="font-size: 12.50px; " x="45.373386" y="0">
2</gydF4y2Batspan>
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</text>
</g>
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</svg>、职责)未达到统计上的显著水平。</gydF4y2Bap>
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<td>葡萄糖和胰岛素反应实验时间和压力之间的OGTT(实线)和控制(折线)条件。数据意味着±se;<gydF4y2Basvg height="10.8125" id="M49" style="vertical-align:-0.10033pt" version="1.1" viewbox="0 0 48.4375 10.8125" width="48.4375" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,10.8125)">
<g transform="translate(72,-63.35)">
<text transform="matrix(1,0,0,-1,-71.95,63.5)">
<tspan style="font-size: 12.50px; " x="0" y="0">
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<tspan style="font-size: 12.50px; " x="14.103384" y="0">
=</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="26.143772" y="0">
1</gydF4y2Batspan>
<tspan style="font-size: 12.50px; " x="32.395271" y="0">
7</gydF4y2Batspan>
</text>
</g>
</g>
</svg>。转换为国际单位制(更易),葡萄糖值乘以0.055。</gydF4y2Batd>
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<span class="caption-text">图4</gydF4y2Baspan>
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<td>葡萄糖响应曲线获得超过24小时<gydF4y2Bai>通过</gydF4y2Bai>cgm后压力(实线)和控制(折线)条件。数据平均值;时间=每天的时间;<gydF4y2Basvg height="10.8125" id="M50" style="vertical-align:-0.10033pt" version="1.1" viewbox="0 0 48.4375 10.8125" width="48.4375" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,10.8125)">
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7</gydF4y2Batspan>
</text>
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</g>
</svg>。转换为国际单位制(更易),葡萄糖值乘以0.055。</gydF4y2Batd>
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<h4 id="discussion">4所示。讨论</gydF4y2Bah4>
<p>适应压力常常需要激活下丘脑一垂体一肾上腺轴(HPA)为了动员能量存储。尽管皮质醇的anti-insulin和gluconeogenetic行动符合这个概念出现,有有限的实验证据支持这个观点<gydF4y2Baa href="#B8">8</gydF4y2Baa>]。我们观察到显著的证据认为压力和心血管订婚30分钟心理物理压力在健康老年人,虽然HPA响应相对于反应出现,挡住了其他研究中观察到的老年人<gydF4y2Baa href="#B21">21</gydF4y2Baa>,<gydF4y2Baa href="#B22">22</gydF4y2Baa>]。我们观察到古老的研究对象(即。,≥70 years) had significantly greater basal cortisol concentrations compared with younger (<70 years) subjects, which is consistent with what has been proposed by Seeman and Robbins [<a href="#B23">23</gydF4y2Baa>),也许反映了适应老龄化负担,作为感知压力相比,最古老的学科分数明显高于年轻组(<gydF4y2Basvg height="12.2375" id="M51" style="vertical-align:-1.09097pt;width:64.662498px;" version="1.1" viewbox="0 0 64.662498 12.2375" width="64.662498" xmlns="http://www.w3.org/2000/svg">
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</svg>)。我们假设相反,3 h post-OGTT葡萄糖和胰岛素浓度升高同样在两种情况下,建议压力挑战的影响不大<gydF4y2Bai>本身</gydF4y2Bai>短期血糖控制在那些年长的和小于70年。此外,CGM提供证据表明,严格的葡萄糖稳态数据可能只是最小压力事件后改变健康的老年人。任何细微的差别在血糖控制明显挑战已经完全消散后6小时到24小时,和cgm数据平均24 h表示没有总体响应的差异后,压力和控制条件。这些发现是否表明高度成功的弹性(相对于正常)老化,正常的aging-specific自我平衡的控制,或我们的研究方法论的差异,其他的还不清楚。</gydF4y2Bap>
<p>一般来说,研究应用压力在禁食状态观察到明显削弱了皮质醇和微不足道的血糖反应(<gydF4y2Baa href="#B8">8</gydF4y2Baa>,<gydF4y2Baa href="#B9">9</gydF4y2Baa>)与应力应用于餐后状态(<gydF4y2Baa href="#B8">8</gydF4y2Baa>,<gydF4y2Baa href="#B9">9</gydF4y2Baa>,<gydF4y2Baa href="#B24">24</gydF4y2Baa>),这表明准备获取能源是必要的宽容HPA反应对血糖控制的影响。我们应用心理物理应力在禁食状态(认为流行的葡萄糖会充足的存储在这个老年人的葡萄糖的量和希望避免大型游览),这很可能解释了钝化皮质醇和最小压力的反应对3 h postchallenge代谢控制的影响。</gydF4y2Bap>
<p>有趣的是,2 h postchallenge血糖反应OGTT(以~ 12:30)明显升高的压力和控制条件,而清晨筛查OGTT (<gydF4y2Basvg height="12.05" id="M54" style="vertical-align:-1.09097pt;width:56.849998px;" version="1.1" viewbox="0 0 56.849998 12.05" width="56.849998" xmlns="http://www.w3.org/2000/svg">
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</svg>毫克<gydF4y2Bai>·</gydF4y2Bai>戴斯。莱纳姆:<gydF4y2Basup>−1</gydF4y2Basup>,分别地。,for the stress, control, and screening conditions). These previously reported late-morning exaggerated glycemic excursions [<a href="#B25">25</gydF4y2Baa>)可能是由于昼夜胰岛素分泌下降报道在老年人每天这个时候<gydF4y2Baa href="#B26">26</gydF4y2Baa>),很可能阻止任何进一步的与压力相关的中断。然而,也有其他证据表明,一个压力的挑战并不会增加整体血糖反应,而是变化的峰值响应,暗示与压力有关<gydF4y2Bai>延迟</gydF4y2Bai>在葡萄糖吸收肠道(<gydF4y2Baa href="#B23">23</gydF4y2Baa>]。我们postchallenge葡萄糖和CGM响应曲线符合这个延迟吸收现象,从OGTT的胰岛素浓度,胰岛素峰值响应从90分钟到120分钟。尽管如此,如果我们考虑OGTT的触发设置应激适应控制反应运动,我们观察到只有轻微的变化控制压力与控制后condition-evidenced小滞后的葡萄糖响应峰值在挑战后30 - 40分钟,葡萄糖的速度较慢,间隙在随后6小时(但不是之外),和血糖控制的稍微更大的个体差异。符合HPA反应研究在餐后状态(<gydF4y2Baa href="#B8">8</gydF4y2Baa>,<gydF4y2Baa href="#B9">9</gydF4y2Baa>,<gydF4y2Baa href="#B24">24</gydF4y2Baa>),更大的燃料供应2 h后重新喂料可能会导致更大的平均postlunch葡萄糖浓度后,压力相对控制条件,尽管prelunch值是相同的。这些细微的差别就不会被发现,而无需使用CGM / 24小时。</gydF4y2Bap>
<p>选择生存的问题是一个重要的考虑在执行挑战研究8日和9日的人几十年的生活。的确,成功老化的一个标志是更大的生理弹性各种环境扰动而没有幸存下来的人,年龄或不能满足入选标准的研究。因此,尽管我们每天使用一个压力源,模拟挑战经常遇到在现实生活中,它可能没有足够的强度或持续时间等一个健壮的老年人口。这个问题的刺激可能特别有问题的不足给国米的程度和个体内的变化对压力的生理反应,很明显在我们的数据和他人的<gydF4y2Baa href="#B21">21</gydF4y2Baa>,<gydF4y2Baa href="#B27">27</gydF4y2Baa>]。同时,压力的挑战是应用在早晨,当葡萄糖浓度最低。我们进行了压力的挑战在下午晚些时候,当皮质醇浓度达到日常最低点时,我们可能会看到一个更大的相对增加HPA反应其他人(<gydF4y2Baa href="#B21">21</gydF4y2Baa>,<gydF4y2Baa href="#B22">22</gydF4y2Baa>]。然而,由于胰岛素分泌下降可能周日下午晚些时候,葡萄糖反应在两种条件下会被夸大了甚至比我们观察到,从而进一步掩盖任何压力诱导效应。</gydF4y2Bap>
<p>总之,压力之间的关系的本质和葡萄糖体内平衡仍然是难以捉摸的,可能受到许多个人、环境、时间条件。使用CGM允许我们揭露一些微妙的短期与压力相关的中断,但这些改变消散在这24小时健康样本。另一方面,由于环境的数量(例如,开车、购物)和心理压力遇到日常的普通人群中老年人,这些发现可能有更大的相关性较低的健壮的已经存在障碍的患者在血糖控制和糖尿病患者。</gydF4y2Bap>
<h4 id="acknowledgments">确认</gydF4y2Bah4>
<p>作者感谢医院的护理和技术人员研究单位的耶鲁大学临床研究中心的技术专长和致力于这项研究的研究对象。本文是由CTSA目前批准号UL1 RR024139从国家研究资源中心(NCRR)的一个组成部分,国家卫生研究院(NIH)和国家卫生研究院的医学研究路线图。其内容是完全的责任作者,不一定代表官方的观点NCRR或国家卫生研究院。这项工作是由格兰特NIH / NIA一下R21 AG.027470(自民党)。</gydF4y2Bap>
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1864年</gydF4y2Badiv>
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961年</gydF4y2Badiv>
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